| NPI | 1689072001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 006030) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 123858) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000194) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R234704) | |
| 163W00000X Registered Nurse (Licence: FL RN9333438) | |
| 163W00000X Registered Nurse (Licence: CA 688397) | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2022-03-31 |